Biden, Ryan Trade Barbs and Claims

by David Pittman David Pittman,Washington Correspondent, MedPage Today
October 11, 2012

Dueling plans for the future of Medicare took stage Thursday night in the only vice presidential debate, with the candidates' words mostly reflecting their campaigns' messages thus far.

Vice President Joe Biden denounced the Republican plan to transform Medicare into a premium-support model for those 54 and younger, saying it would shift the escalating costs of healthcare away from the government and onto beneficiaries.

The plan offered by Ryan would offer on average $8,000 to those who turn 65 in 2023 or later to offset the cost of buying health insurance. The plan has drawn criticism from opponents who say the amount seniors would receive wouldn't rise fast enough to keep pace with the cost of insurance, forcing seniors to pay as much as $6,400 a year themselves.

"You are jeopardizing the program. You're changing the program from a guaranteed plan to a premium support, whatever you call it. The bottom line is people are going to have to pay more money out of their pocket," Biden said at the end of the only 10-minute segment dedicated to healthcare. "The families I know, where I come from, they don't have the money to pay out of their pocket."

Ryan defended his plan, saying Medicare is going broke and needs reform to save it from its own growing weight.

"The best way to do it is reform it for my generation, people 54 and below," the congressman said. "Give younger people when they become Medicare-eligible guaranteed coverage options, that you can't be denied, including traditional Medicare. Choose your plan and then Medicare subsidizes your premiums."

Ryan said his plan would include more support for lower-income people and less for the wealthy, and complete coverage for the poor and sick. "We would rather have 15 million future seniors determine how their Medicare is delivered to them instead of 15 bureaucrats deciding what, if, where, and when they get it."

Ryan attacked the Affordable Care Act (ACA) once more with the familiar claim it will slash $716 billion in Medicare by the next decade. But Biden refuted that, saying the ACA was supported by the American Medical Association (AMA) and others.

"Who you gonna believe more? The AMA?" Biden asked. "Or someone who actually put in motion a plan that knowingly [adds] $6,400 a year to the cost of Medicare."

The vice president also reiterated the Obama administration's position that it is squarely against vouchers for Medicare. Instead, the Obama administration would keep the Medicare program as it is now -- a guaranteed benefit under which beneficiaries can choose between private insurance-run plans and traditional Medicare.

As his presidential running mate, former Massachusetts Gov. Mitt Romney, did last week, Ryan also attacked the ACA's Independent Payment Advisory Board, a 15-member panel designed to offer cost controls if the cost of Medicare spending rises a certain percentage faster than inflation.

But unlike last week, Medicaid wasn't mentioned at all and the benefits and limitations of the ACA received scant attention.

The debate did touch on the ACA's requirement that large employers be required to offer contraceptive coverage to employees free of charge. Ryan, who is Catholic, alleged that the requirement discriminated against Catholic hospitals and charities, which do not support the use of contraception. "Our churches shouldn't have to sue the federal government to protect their religious freedom," he said.

Biden, who is also Catholic, responded that no Catholic institution is required to refer, pay for, or be a vehicle for contraceptive coverage.

Both candidates also discussed their views on abortion. Ryan said that, consistent with his religion, he believes that life begins at conception and that "the policy of a Romney administration will be to oppose abortion with the exceptions for rape, incest and life of the mother."

Biden said that although he accepted his church's position on abortion in his personal life, "I refuse to impose it on equally devout Christians and Muslims and Jews ... I do not believe that we have a right to tell other people that women, they can't control their body. It's a decision between them and their doctor, in my view."

Unlike the first presidential debate last week, Thursday's debate dealt with both domestic and foreign policy. Of the two areas, foreign policy appeared to dominate the debate, which was moderated by ABC News Foreign Correspondent Martha Raddatz.

President Obama and Republican challenger Romney square off in their second debate Tuesday at Hofstra University in Hempstead, N.Y.

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